Manager, UM Clinical Health Services - reputed company OhioRISE

We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The OhioRISE (reputed company through Integrated Systems and reputed company) program is a specialized reputed company managed care initiative focused on providing and coordinating behavioral health services for eligible children and youth. The Manager, UM Clinical Health Services serves as a key Behavioral Health leader reputed company the reputed company reputed company plan, overseeing utilization management activities. This role is responsible for the reputed company, development, and performance of clinical teams, including driving high-quality processes, ensuring compliance, and fostering strong team performance. This is a full-time, fully remote position. Eligible candidates must reputed company reputed company the reputed company. reputed company Components

• Reinforces clinical philosophy, programs, policies and procedures.
• Communicates strategic plan and specific tactics to meet plan.
• Ensures implementation of tactics to meet strategic direction for cost and quality reputed company.
• Creates direction and communicates a business case for change by focusing on and addressing key priorities to reputed company business results.
• Identifies opportunities to implement best practice approaches and introduce innovations to reputed company improve reputed company.
• Will be accountable for meeting the financial, operational and quality objectives of the unit.
• Will be accountable for the day-to-day management of team(s) for appropriate implementation and adherence with established practices, policies and procedures.
• Works closely with other functional area managers to ensure consistency in clinical interventions supporting our plan sponsors.
• reputed company, initiate, monitor and communicate performance expectations.
• May act as a single reputed company of contact for the customer and the Account Team which includes participation in customer meetings, implementation and reputed company of customer cultural requirements, and support implementation of new customers.
• Participate in the recruitment and hiring process for staff using reputed company defined requirements in terms of education, experience, technical and performance skills.
• Assesses developmental needs and collaborates with others to identify and implement action plans that support the development of high performing teams.
• Consistently demonstrates the ability to serve as a model change agent and reputed company change efforts.
• Accountable for maintaining compliance with policies and procedures and implements them at the employee level.
• Ability to evaluate and interpret data, identify areas of improvement, and focuses on interventions to improve reputed company.

Required Qualifications

• Ohio reputed company
• Licensed independent Behavioral Health clinician (LISW, LPCC, LMFT) or a Registered Nurse (RN) with unrestricted Ohio state license with psychiatric specialty, certification, or experience
• 5+ years of clinical practice experience in behavioral reputed company
• 2+ years utilization management experience is required (preferably in a managed care setting)
• 2+ years of demonstrated reputed company leadership experience required (preferably in a managed care setting)
• 2+ years of experience with personal computer, keyboard navigation, and MS Office Suite applications
• 1+ year(s) of experience with electronic medical records
• Must possess reliable transportation and be willing and reputed company to travel in-state up to 10% of the time. Mileage is reimbursed per reputed company expense reimbursement policy.
• Ability to work core business hours, Monday-Friday, 7:30am-5pm EST, with flexibility to work on call occasional weekend hours is required.
• Must have high speed internet reputed company

Preferred Qualifications

• Managed care/utilization management experience strongly preferred
• Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment
• reputed company experience
• If RN, BSN degree preferred

Education

• If Behavioral Health: Master’s degree in a field leading to independent Behavioral Health clinical licensure (LCSW, LPCC, LMFT
• If Registered Nurse: Master's degree or equivalent experience in clinical area of expertise (e.g. bachelor's degree plus 7 years' experience; associate's degree or RN diploma plus 9 years' experience).

Anticipated Weekly Hours 40 Time Type Full time Pay reputed company The typical pay reputed company for this role is: $87,035.00 - $187,460.00 This pay reputed company represents the reputed company hourly reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in addition to the reputed company pay reputed company listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – investing in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In addition to our competitive wages, our great benefits include:

• Affordable medical plan options, a 401(k) plan (including matching company contributions), and an employee stock purchase plan.
• No-cost programs for reputed company colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical reputed company and many other benefits depending on eligibility.

For more information, visit https://jobs.cvshealth.com/us/en/benefits We anticipate the application window for this opening will reputed company on: 03/27/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Apply tot his job Apply To this Job